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Prognostic factors for persistent middle ear effusion after acute otitis media in children
Y Iino1, Y Nakamura, T Koizumi
1Department of Otolaryngology, Teikyo University School of Medicine, Tokyo, Japan.
Insights
Young children with acute otitis media (AOM) face higher risks of persistent middle ear effusions. Examining the opposite ear is crucial for predicting AOM
Area of Science:
- Pediatrics
- Otolaryngology
- Epidemiology
Background:
- Acute otitis media (AOM) is a common childhood illness.
- Persistent middle ear effusions can lead to complications.
Purpose of the Study:
- To determine the clinical course of AOM in children.
- To identify risk factors for persistent middle ear effusions.
Main Methods:
- A cohort of 120 children aged 9 months to 10 years diagnosed with AOM was studied.
- Clinical factors at onset were analyzed to identify risk factors for persistent effusion.
Main Results:
- 52% recovered within a month, 22% resolved in 1-3 months, and 26% had persistent effusions (>3 months).
- Significant risk factors included younger age, bilateral AOM, otorrhea, and specific tympanogram types (B or C2) on the affected or opposite ear.
- Tympanogram type B or C2 on the opposite ear was the most significant prognostic factor.
Conclusions:
- Younger age, bilateral AOM, otorrhea, and specific tympanogram findings predict persistent middle ear effusions.
- Examination of the contralateral ear is vital for predicting the clinical course of AOM.
Abstract:
The present study was carried out to determine the clinical course of acute otitis media (AOM) in children and to analyze the risk factors that lead to persistent effusion. One hundred and twenty children aged 9 months to 10 years diagnosed as having AOM were included in this study. Sixty-two children (52%) recovered from AOM without middle ear effusions within a month. In 26 cases (22%), middle ear effusions resolved after 1 to 3 months, while 32 children (26%) had persistent effusions for more than 3 months after the onset of acute inflammation. Statistical analysis between the group showing quick recovery and that with persistent effusion was carried out in relation to various clinical factors at the onset. The significant risk factors were: younger age, bilateral AOM, presence of otorrhea, tympanogram type B or C2 on an AOM ear. Moreover, the most significant prognostic factor was a tympanogram type B or C2 on an opposite ear at the acute onset. On the other hand, factors such as sex, fever, history of otitis media, season at onset or complications did not correlate with the duration of persistent effusion. From these results we conclude that careful examination should be performed not only on the ear with AOM but also on the opposite ear in order to predict the course of otitis media.